Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

AVERA MCKENNAN

NPI: 1104892892 · SIOUX FALLS, SD 57105 · Nephrology Physician · NPI assigned 02/23/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official PLACE, RONALD controls 20+ related entities in our dataset. Read more

$902K
Total Medicaid Paid
19,026
Total Claims
10,394
Beneficiaries
14
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialPLACE, RONALD (CEO/PRESIDENT)
NPI Enumeration Date02/23/2006

Related Entities

Other providers sharing the same authorized official: PLACE, RONALD

ProviderCityStateTotal Paid
AVERA MCKENNAN SIOUX FALLS SD $6.68M
AVERA MCKENNAN SIOUX FALLS SD $5.34M
AVERA MCKENNAN SIOUX FALLS SD $4.07M
AVERA MCKENNAN SIOUX FALLS SD $3.71M
AVERA MCKENNAN SIOUX FALLS SD $3.24M
AVERA MCKENNAN SIOUX FALLS SD $1.04M
AVERA MCKENNAN SIOUX FALLS SD $1.03M
AVERA MCKENNAN MILBANK SD $899K
AVERA MCKENNAN SIOUX FALLS SD $815K
AVERA MCKENNAN SIOUX FALLS SD $758K
AVERA MCKENNAN SIOUX FALLS SD $545K
AVERA MCKENNAN SIOUX FALLS SD $318K
AVERA MCKENNAN ROCK RAPIDS IA $186K
AVERA MCKENNAN SIOUX FALLS SD $156K
AVERA MCKENNAN GREGORY SD $80K
AVERA MCKENNAN MITCHELL SD $70K
AVERA MCKENNAN SIOUX FALLS SD $68K
AVERA MCKENNAN SIOUX FALLS SD $54K
AVERA MCKENNAN SIOUX FALLS SD $54K
AVERA MCKENNAN FLANDREAU SD $53K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 3,878 $167K
2019 3,778 $160K
2020 1,929 $84K
2021 3,075 $152K
2022 2,847 $139K
2023 1,525 $82K
2024 1,994 $119K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90961 2,163 2,073 $190K
99232 Subsequent hospital care, per day, moderate complexity 5,512 1,541 $180K
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits 1,567 1,485 $126K
90935 Hemodialysis procedure with single evaluation by a physician 3,384 1,056 $124K
99233 Prolong inpt eval add15 m 2,334 654 $104K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 1,595 1,434 $55K
99223 Prolong inpt eval add15 m 493 455 $46K
90962 635 593 $42K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 581 513 $12K
99222 Initial hospital care, per day, moderate complexity 282 245 $11K
90970 215 122 $7K
99215 Prolong outpt/office vis 69 65 $3K
99231 Subsequent hospital care, per day, straightforward or low complexity 61 28 $1K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 135 130 $295.69